News

island of Guam have ruled that DNA fingerprinting still lacks a scientific consensus. The worry is that a DNA test could give a positive result by chance because the exact genetics of the population are not known. On 8 September the United States Law Week ' i reported that "ongoing debate about the impact of population substructure on the statistical validity of DNA 'matches'noted in a National Research Council reportF released in April-prompted the Massachusetts Supreme Judicial Court [on 20 July] to Fingering the evidence: how accurate is DNA fingerprinting? conclude there is a lack of general scientific acceptance conceming the method Cellmark Diagnostics laboratory and the Federal Hospital in Baltimore, Maryland, held a wrong person (BM7, 18 January, p 139). Bureau of Investigation use to calculate DNA press conference to denounce the newspaper's Fisher told the BMJ that the American profile frequencies." And two weeks ago article and "confirm the general reliability of Association of Crime Lab DirectorsNature reported that the California Court of using DNA typing in forensic science." Laboratory Accreditation Board, which he Appeals and the US District Court of Guam The New York Times corrected its error the chairs, would propose standards of accreditahad also ruled "that the scientific uncertainty next day. But the damage had been done. tion for forensic DNA testing to its members over the role of population substructure in An aid to Congressman Don Edwards, a at the end of this month. calculating the chance ofDNA matches is too Democrat in California, told the industry Fisher said that the state's attorney general great to pass the so-called Frye test, a newsletter Biotechnology Newswatch that would appeal against the Bamey-Howard measure of scientific acceptance needed for the article was "clearly overstated. Unforruling to the California Supreme Court. legal acceptability set out in a 1923 decision tunately, the response [by McKusick] was "There's a difference of opinion between by the US Supreme Court." to understate the report's conclusion. The academics and people in the trenches," The appeals decision in California affected report is quite critical of the way DNA Fisher said. He noted that estimates for a two cases-a murder (Howard) and an evidence has been handled up to now." DNA match occurring by chance ranged attempted rape (Barney)-in which blood Indeed, the conclusion of the National from 1 in 10 000 to as high as 1 in 738 million and semen samples were the sources ofDNA Research Council's report is not clear. "DNA million. "I don't care," he said. "Even if it's analysed by a crime laboratory. "Howard and typing for personal identification is a powerful 1 in 10000 that's more than enough."Bamey raise almost identical issues pertaintool for criminal investigation and justice," it REGINALD RHEIN, medical journalist, ing to the question whether there is general says. "At the same time, the technical aspects Washington, DC scientific acceptance ofDNA analysis and the of DNA typing are vulnerable to error, adequacy of the [Frye test] in each case," the and the interpretation of results requires court said. appreciation of the principles of population The National Research Council's report genetics." One of the report's main recom"acknowledges there is a 'substantial contromendations is that "courts should require DNA accepted in versy' concerning the present method of that laboratories providing DNA typing statistical analysis," the court said. The court evidence have proper accreditation for each British courts noted that the report "does not, however, DNA typing method used." Another is that choose sides in the debate, but instead the Department of Health and Human DNA profiling is widely accepted in Britain's 'assumes for the sake of discussion that Services should establish mandatory accredicriminal courts, although the Court ofAppeal population substructure may exist."' tation, in consultation with the Department has not so far formally considered the techThe reseach council, an arm ofthe National ofJustice. nique. Criminal lawyers could not think of a Academy of Sciences, issued its report DNA Despite the controversy, prosecuting attorcase where a judge had thrown such evidence TechnologSy in Forensic Science on 14 April. neys are confident that forensic DNA tests out. The danger, according to Peter AllThat morning an article in the New York will be accepted in all US courts eventually, dnidge of Cardiff Law School, writing in this Times predicted that the council's study said Barry Fisher, who directs the crime month's Criminal Law Review, is that DNA committee would conclude that DNA tests laboratory for the Los Angeles Sheriff's profiling may be considered infallible and "should not be allowed in court in the future Department. Several months before the defence lawyers may regard the evidence unless a more scientific basis is established." report was issued the Federal Bureau of as unchallengeable. "What appears to have But the study committee's chairman, genetiInvestigation changed the way it calculated happened is that the mere mention of DNA cist Victor McKusick of the Johns Hopkins the odds that DNA typing would identify the evidence for the prosecution has generated

guilty pleas," he says. In one case a legal aid Headlines committee refused defence solicitors the costl of forensic work on the ground that DNA evidence was incapable of challenge.
Even a High Court judge, Mr Justice Rome bns smoing: A Italin en-Alliott, confessed last year at the Old Bailey restaurants, and indoor markets and samples were used as a basis for what the 9*^^_ ; willnmetakeeffectein cthree w geekstieprosecution said were "very, very long odds"l against pinpointing the wrong person. __ " US public health system fails to The judge threw out the case, which_t attack diseases: A report from the involved a 37 year old Mghan, beeause rap N ational Academy of Science urges of "incompetence" by the prosecution unhealth officials to be aware of the |Hrelated to the DNA tests. He said he wasl potential for epidemics. The report disappointed that there would be no resolui says that public health surveillance tion of a problem about DNA evidence which systems are unable to detect threats he had not been aware of before reading the from either new diseases such as AIDS defence material._ or the re-emergence of tubereulosis.
In Britain new forms of scientific est M iu w whceh prove to have forensic appleations are British government relaxes adoption introduced in the courts on an ad hoc basis.

rules: Local authorities will no longer
The only test is that they must be relevant Tandem IQ. The controversy over the effects be allowed to impose upper age limits andhelpful. IntheUnitedStates,bycontrast, of supplements on children's IQs, which on adoptive parents under changes any new scientific te u h o pass the dates from a study in 1988 by Dr David to the adoption law proposed by a "Frye test" of general acceptance in the Benton, a research psychologist at the Unigovernment working party. Racially scientifioeommunity.
versity College of Wales at Swansea, was mixed adoptions will also be allowed. Mr Alidridge points out that DNA evi-thrashed out over five days at Shrewsbury Preference will still be given to dence is not proof against human error, and magistrates'court. married couples. Children over 12 ean challenges may be mounted on two grounds: Shropshire trading standards department, vetoiany adoptiondplans.
technical errors in carrying out the test and which brought the case, alleged that the the inferences to be drawn from the results packaging of Tandem IQ, which showed two German controversy over dead based on population geneties. But statistical ehildren reading, gave the impression that mother's fetus: In an attempt to save arguments about whether pattens un-the product could improve the intelligence of her 14 week old fetus an 18 year old common in the general population might be all children, not just those who were poorly dental nurse is being artificially venti-common in the defendant's ethnic group nourished. David Roberts, chief trading lated after a car accident. The case has have not had much play in Britain, and Home standards officer, said: "We're pleased with aroused controversy in Germany since Office forensice sientists regard the question the outcome. It vindicates the view that the the aecident on 5 October. News-ofethnieity as a tred herring. experts advising us took, that this was too papers have accused doetors of being DNA profiling and scientifie evidence general a claim. It ats as a wamring to others perverted in their judgment. generally is one of the subjects under to make sure they use scientific evidence review by the Royal Commission on Criminal carefully." University staff's reduced pay rise: Justie, set up in the wake of a series of products couldboostchildren's IQs. Larkhall two maufacturers Seven Seas and Raw They are encouraged by the suggestion Natural Health was fined £1000 and ordered Power pleaded guilty earlier and were each that the Department of Health might to pay £35 000 prosecution costs after being fined £4000 for making false claims about increase the quota of medical students found guilty on three charges under the their respective products, Boost IQ and by s 0o.
Trade Descriptions Act over the packaging Vitachieve.bLAe DYER, legal corresponaims._Peppermint_will_no_longer beanufacturersfined mixtureofof its vitamin and mineral supplement, dent, BMJ Labour's policy for and people eat a lot of shellfish in Hong developing for 40 years and that's how long Kong." these pollutants have been building up in the London s health Half of Hong Kong's daily sewage and bottom sediments," said Mr Morritt. "At the waste water stream is untreated, and a further moment there is a great deal of dredging 40% undergoes only primary' treatment to going on for land reclamation and the sediremove solids. "Just 1O0% receives proper ments are being disturbed. These dangerous London's health services last week, supporttreatment," according to Ms Joanna Ruxton, pollutants -are being spread throughout ing a shift of resources into primary health marine conservation officer for the World the marine ecosystems."-FRED LENIHAN, care and the development of community Wide Fund for Nature in the colony. "People freelance journalist, Bangkok health centres. But Labour states that no are increasingly concerned. It became a big hospitals should be closed until alternative issue recently when the colony's sewage services have been set up under the superstrategy was shelved, and we decided to vision of a special task force that will report to collate all the existing information on water a new regional health authority for London.

Drug com anies
In a statement of principles Mr David poluion into one report. It's been well pusay Blunkett, shadow health secretary, says that areceivedgand we u eristnth auto i f oi change must be managed carefully over Rextang an adequate timescale. He warns against Rton.

Canada
It is estimated that it would cost $3-2 bn c s t. hospital closures being based on financial gain from sales of prime sites. But he also (K2 n opoieHn ogwt c fentralised treatment system for sewage and The latest evidence of the flourishing partnerwants to ensure that "vociferous advocates"' wants to ewaste water. The new governor, Chris Patten, ship between university research and the of a particular hospital do not override the recently allocated HK$3 bn for the project, pharmaceutical industry is the announceinterests of local people.
Laboureattributes Leondon' health crisis although overall financing remains uncertain. ment that Canada's first Centre for Molecular Labour attributes London's health cnlsis. ..
. to consistent underfunding and suspects the Mr Morritt explained: "Because the public Medicine and Therapeutics will be estabgoverment of using Sir Berard Tomlinson's expenditure figures are so large it does require lished at the University of British Columbia report on health care in London to implement a great deal of thought, but the colony is with the aid of a Can$15 million grant from freaching a crisis point." Merck Frosst Canada Incorporated. The furthr cs aIn addition to heavy organic pollution in the grant is the largest for extramural research of new NHS trusts and general practitioner colony's coastal waters, figures show increas-Merck has ever made worldwide, and the fundholders to be suspended and key spefu ndhosderslt besueed and key v spe ingly serious heavy metal contamination in biggest made by any drug firm to research cialtistihospitals reoedfomtevaaie fsediment layers in the bays. Much of this based in a Canadian university. com t ion . stems from Hong Kong's many thousands The new centre will be dedicated to under-Labour also proposes greater integra of small metalworking factories, which standing the genetic causes of disease and of medical training with the capital's academic discharge their untreated, toxic wastes developing clinical strategies and new drugs. institutions, possibly leading to the establishdirectly into storm drains. Activists claim Scientists will interact with the more than ment of a London medical science park.that heavy metal pollution will pose another 4000 scientists in Merck's laboratories JOHN WARDEN, parliamentary correspondent, serious health threat.
around the world. BMJ The Hong Kong Environmental Protection The director will be a specialist in Hunting-Department's own statistics show bottom ton's disease, Dr Michael Hayden, professor sediment readings in Kowloon Bay at 8800 of medical genetics at the University of mg/kg for copper, 680 mg/kg for chromium, British Columbia. He is also director of the 9-6 mg/kg for cadmium, and 620 mg/kg for Canadian Genetic Diseases Network, a Untreated sewage zinc. The sediment contamination that the consortium of Canada's leading genetics authorities use as a benchmark for action is researchers linked with universities and brings hepatitis to recorded at 65, 80, 1-5, and 200 mg/kg industry.
respectively. "The level of heavy metal and Prime minister Brian Mulroney's govern-Hong Kong toxic pollution in some of the bays is another ment has strongly encouraged research by real health worry. Hong Kong has been the pharmaceutical industry. In 1987 it A dramatic rise in the incidence of hepatitis A and gastrointestinal disorders in Hong Kong in the first half of this year has been linked to the daily discharge of two million tonnes of' mainly untreated sewage and waste water into the colony's heavily polluted coastal waters. A report published jointly this month by three environmental action groups claims that 2242 cases of hepatitis A were reported to the public health department in the first six months of this year-70% above the total of 1297 for the whole of last year. Water Pollution in Hong Kong: A Time to Act states that "the population is at greater risk of. general stomach disorders, as well as eye infections, ear infections and skin rashes." for Frieds of the Eart in Hong Kiong, said, z Hepatitis A is transmitted through sewage in __-S <srXXiIu the coastal waters, and because so much of it _0i_5 is now being dumped untreated in the bays -_-g z the marine ecosystem is suffering heavier || problem because they become contaminated Untreated water is ruining Hong Kong's health passed Bill C-22, extending market exclu-dex Leluk questions the board's methods. that the winter is democratic. It will kill the sivity for drugs for 7-10 years in return for Leluk points out that provincial health children from all sides." promises of increased research and develop-ministries face rising drug costs-close to Unicef are putting out adverts 12 times ment expenditures by the drug companies. $900 million this year in the case of Ontario. a day on Croat and Serbian television-The companies responded by more than There the rise has been close to 20% annually, promoting the week of tranquillity. "If it fails doubling such expenditures. Last January in Alberta 18%, and in Quebec 17-5%. Pro-then there will be scenes like the siege the government endorsed a General Agreevincial health ministers have set up a task of Leningrad-with hundreds of thousands ment on Tariffs and Trade (GATT) proposal force to study how to reduce costs-DAVID of children and elderly dying" said Edith that extended patent protection by a further SPURGEON, medical journalist, Canada Simmons. "The television cameras will be three years on average. The industry in-there to record it and the world will find it creased its research and development investunbearable to watch." ments to about Can $400 million. Last June There are now over 1 350 000 refugees in the government introduced Bill C-91, which g Bosnia-Herzegovina-most of them women follows the GATF proposals.
Unicef gets ceasefire and children, according to Unicef s latest British Columbia's government is expected figures. Unicef estimates that over 317000 to pay for the new centre's building, and In fo er Yugoslavia children, pregnant women, and nursing hopes that this will lead to establishment of a mothers in Bosnia-Herzegovina urgently pharmaceutical industry on the west coast. Unicef have received a firm promise from all need supplenmentary feeding. The numbers So far, most of the industry is centred around the political leaders in the former Yugoslavia are higher in Serbia and Croatia, where Toronto and Montreal.
for a one week ceasefire beginning on 1 crowded collective shelters increase the risk Merck Frosst Canada said that it will only November. The ceasefire will allow convoys of epidemics, which are now more likely with go ahead with the new centre if Bill C-91 is to reach up to one million children, bringing the onset of winter. Sarajevo is trying to passed into legislation. But the bill is strongly them winter clothes, blankets, medicines, restore its electricity and water supplies. opposed to generic drug manufacturers, who and vaccines. "We have talked to every Hospitals in most of the former Yugoslavia claim that it will lead to a rise in drug prices.
political leader in this conflict," said Edith are already short of basic drugs, vaccines, Nicholas Leluk of the generics' Canadian Simmons, Unicef s liaison officer in former and medical equipment. A quarter of all Drug Manufacturers Association maintains Yugoslavia. "We have got a military under-the working space of hospitals and health that prices of new drugs are now higher than taking that they will stand down for a week of centres has been destroyed. before as a result of Bill C-22. But the Prices tranquillity for the children. We believe that Unicef says that 1417 children have and Medicines Review Board, set up to it will work where other ceasefires have not been killed and 29 169 wounded in Bosniamonitor prices after Bill C-22, claims that because we have looked these people in the Herzegovina since the war started. Unicef between 1987 and 1990 prices of existing eyes and asked them how much they care predicts that if the ceasefire is unsuccessful patented drugs remained consistently below about their children. If someone shoots-the children will be dying of starvation within its guidelines and the Consumer Price Inwhole world will see it. We have told them three weeks.

976
BMJ VOLUME 305 24 OCTOBER 1992~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ the right and duty to raise with their employ-of providing oxygen concentrators at home ing authority or trust any matter of concem for people with chronic bronchitis might ......X i they may have about health service issues. seem too high if researchers did not wait to t;; _E Stating that the interests of patients are see the long term benefits. To avoid throwing paramount, the guidance,says that employees out such valuable interventions a thorough have a duty to draw to the attention of system of assessment is needed. managers any matter they consider to be Firstly, all possible outcomes of introducdamaging to patient interests and to put ing a new technology should be considered.
forward suggestions for improvement. These may include clinical, administrative, Each NHS employer' should draw up financial, and social implications. For policies and procedures locally to enable the example, the widespread introduction of day rights and duties of staff to be fully and fairly surgery has required many changes for met. Under no circumstances are employees surgical units and more work for relatives to be penalised for using the procedures. and district nurses-all outcomes that need If grievances cannot be resolved informally to be assessed.
they can be formally referred all the way up to When randomised trials are impossible or the chairman of the health authority or NHS inappropriate, large observational studies _;; trust.
can provide useful data. Once the data have The main constraints relate to confidenbeen collected they can be used by other tiality. Unauthorised disclosure of personal researchers (particularly before protocols f information about any patient will always for further study are drawn up) and, in 0 warrant disciplinary action. Under common accessible forms, by clinicians, purchasers. law employees also have an implied duty of politicians, and patients.
: confidence and fidelity to their employer.
To assimilate data of high quality the NHS 2 A breach of this duty may also result in should appoint special staff, says the report.
The world waits to se how the militavaluechldren disciplinary action whether or not there The advisory team proposes that a proper The world waits to see how the military value children .
is a clause to that effect in a contract of career structure for health technology assess- The agency estimates that 900 000 children employment. ment is created, along with specialist centres have been traumatised by the war. "I visited As a last resort an employee may "contem-for collecting data. Someone wanting to children who had been living in cellars for six plate the possibility of disclosing to the media know about a new treatment for schizomonths. They had gone without fresh fruit a matter of genuine concem"-but should phrenia, for example, should be able to and had not been to school for six months," first consider the possible consequences of contact a centre where all relevant domestic said Edith Simmons. "I interviewed one such an action. Any unauthorised disclosure and international psychiatric research (both child who had been sitting on his mother's of matters relevant to the employer's published and unpublished) has been lap on a bus that was attacked by snipers. His responsibilities might represent a serious subjected to meta-analysis and stored in an mother was shot dead trying to protect him." breach of contract. Employees are advised to electronic database.
To help children come to terms with their seek advice from their professional or repre-Such databases already exist for certain experiences Unicef has set up workshops for sentative bodies.
diseases, including breast cancer and perilocal psychologists, teachers and for parents The guidance states that all staff must natal problems. Dr lain Chalmers, chairman to learn "first aid trauma." "We ask the retain the right to consult their professional of the Advisory Group on Health Technolochildren to draw a picture of their village organisation or trade union. Comments on gies, which prepared the report, asserts before and after the war or write an essay on the guidance are invited by 13 November to that "there is an appetite for this sort of what they would do if they were president," Peter Hall, NHS Management Executive, information, not only among doctors." For explained Ms Simmons. "These children are Room 234, Quarry House, Quarry Hill, example, many NHS purchasers have confused. In future, says the report, all new health The right of NHS staff to freedom of speech technologies offered to the NHS should first about health service issues and the care be evaluated to see if they make people ofpatiwens a isformallytrecognised iS dora shealtier ateasonae cst. Te terhealth loalrcdresthrounghtaslendewingtlevelsf"ofwae"rsuc ais healtehih edcation, culical n hw_ ansergiallegsatios that alNHS employer shourreld bale abandon ted." BThsoe intia xenoelO-ye thm-otyotauaufroeae BMJ VOLUME 305 as part of the NHS research and development programme. (3 October, p 787.) Doctors who lack the appetite for such data are warned in the report: "Health professionals want to do the best for their patients, but their training often leads them to be more certain than is justified about .+ --A what is best. "-TRISH GROVES, BAl British court orders I I caesarean section An emergency caesarean section was camedout at a London hospital last week after the High Court overrode the mother's objections on religious grounds. In the first case of its kind to reach court in Britain, Sir Stephen_ Brown, president of the court's family divi-N y e sion, granted a London health authority a declaration that the operation would not be unlawful, despite the mother's refusal.
an out of court settlement and an agreement greater emphasis on health promotion activi-In a 23 minute court application, Sir from the hospital that it would set up an in ties encouraged by the -1990 general prac- Stephen was told that the 30 year old mother, house ethics committee to safeguard pregnant titioner contract, the introduction of general Mrs S, had been in labour for two days. The women's rights and would "virtually never" practice fundholding, and the proposals in fetus was full term, in transverse lie, with an take such cases to court in future.
The Health of the Nation. One in six practice elbow projecting through the cervix. The Mr Levy said it seemed that Mrs S could nurses had changed their employment in the only means of saving the lives of the mother also bring a civil action, for assault, if the past six months, most moving from an NHS and her unbom child was to carrv out a Appeal Court ruled that the High Court hospital post. Practice nurses were most caesarean, and it was a case of "minutes declaration was wrongly made. But the satisfied with their work. One nurse comrather than hours," Sir Stephen was told. damages would be likely to be minimal, he mented, "Before being employed as a practice The operation was carried out, but the baby added.-CLARE DYER, legal correspondent, nurse I worked as a district nurse. I moved died. The mother is recovering.
BMt because of the management and lack of Medical lawyers believe the case should go flexibility in what nurses were allowed to do. to appeal, since-as Sir Stephen, England's I am now treated with more respect and am senior family judge, conceded-there is no encouraged to train to develop other nursing authority in English law for a competent s skills." patient's refusal of treatment to be over-Nurses st'll feel The survey was submitted to the nurses' ridden, even if the result is certain death. In review body to back up its claims for an 8-7% addition, earlier cases have established that a overworked and pay rise. The college's secretary, Ms Christine fetus has no rights under English law.
Hancock, commented, "There is clearly a Sir Stephen said there was "some American Unaerpald high level of unpaid, unchosen overtime authority" which suggested that a declaration being worked." She believed that the survey should be made in the circumstances of the Many nurses believe that working above confirmed anecdotal evidence of growing case. However, the case he cited, that of their normal hours is an inevitable part of pressures on nurses.-LINDA BEECHAM, BMJ Angela Carder, established that mothers their job but fear that it makes them unable to Motivation, Morale and Mobility: A Profile of Qualified should be forced to undergo caesareans provide patients with the kind of care they Nurses in the 1990s is published by the Institute of against their will only in "extremely rare" need. A survey of 3000 qualified nurses, by Manpower Studies, Mantell Building, Falmer, and "truly exceptional" cases. The case, the the Institute of Manpower Studies, finds that Brighton BN1 9RF, price £15. first to go to a fully argued appeal, is widely they are still struggling to complete essential credited with having stemmed the tide of tasks, paperwork, and other duties. Less caesareans ordered by American courts, than half of the respondents thought that which were numbered in dozens. they were paid fairly considering their level Margaret Puxon, a QC and former obof responsibility. Two thirds of nurses Royal Society calls stetrician, said that the decision would thought that career prospects were becoming probably be overruled by the Court of Appeal less attractive, and almost half said that they for career changes if Mrs S appealed. Allan Levy QC, who has could eam more money for less work if they for scientists appeared in most of the leading cases on left the profession. consent to treatment, said: "I hope it goes to Despite these findings the proportion appeal-it's too important not to. It should leaving nursing has fallen to under 7% from Poor conditions and career prospects for go to the House of Lords." 1 1% in 1986-7. The report says, "Most researchers were the commonest issues raised Angela Carder, a patient at George nurses have spouses, and in most cases their by themore than300 peopleandorganisations Washington University Medical Center in nursing jobs will be seen as more secure who responded to the Royal Society's Washington, DC, was dying ofcancer and 26 than jobs outside the health care sector." 20 month inquiry into the science base in weeks into her pregnancy when the hospital When asked about job satisfaction only 9%/ Britain published this month. "As profeswon a court order permitting a caesarean were negative about nursing. Three quarters sional scientists we believe that an inadequate against her will and over the objections of her of the nurses were working in the NHS and number are being trained for the next generafamily and the doctors caring for her. Mother most were working in acute specialties. tion . .. the majority of lively, young people, and baby died. The appeal court ruled that Since the early 1980s the number ofnurses with the necessary intellectual gifts, seek the order should never have been granted. employed by general practitioners has risen training in other careers from an early age, After the appeal Ms Carder's parents sued from nearly 4000 in 1984 to over 13000 and we have difficulty in persuading young the hospital and won undisclosed damages in in 1990. The increase has been due to the science graduates to embark on a research career," says one fellow of the Royal Society Indian dam p now colleges have mushroomed-there are in the report. courts 117 recognised and 27 unrecognised medical One reason why the young leave science is down on private colleges in India. Many have lobbied for that they are most likely to be employed on recognition after opening, sometimes exertfixed term contracts. Between 1977-8 and medical schoolsing political and industrial pressure through 1990-1 short term researchers in science and strikes. engineering in universities increased by 6000, In the past few months India's highest courts A further examination of medical training rising from 22% to 44%/ of total academic have condemned the spreading privatisation will be carried out by a special ministerial staff. Between 1979staff. Between -80 and 1989staff. Between -90, 1100 of medical and dental education in several committee set up by the National Developpermanent posts. Were lost, although 300 states The controversy started when the ment Council on Medical Education and led were restored in 1990-1. Another problem Andhra Pradeshstate governmentintroduced by Professor J S Bajaj. The committee will for young scientists is the constraint placed an amendment to an act on educational review the standards required for entry to on research by having to spend time raising funding, thus allowing medical and dental medical school and the quality of education money, teaching, and administering. colleges to charge private fees for up to half of and will attempt to predict future needs for Salaries have also been reduced relative to alltheirplaces medical manpower in India-ZAKA IMAM, others, and Sir Michael Atiyah, president of The state's High Court ruled against the medical writer, Lucknow, India the Royal Society, said that many PhD amendment sigh it wuld contr e students lived below the poverty level. "That equalitycau in the Ind contittin equalilty clauses in 'the Indian constitution makes me very angry," he added. Other makes meveryangy,"he d. O and lead to a two tier system of education.
causes of the young not wanting to enter The High Court also quashed two orders careers in research are the "perceived reducby the state government that would have Launch of Official tion in the prestige of science and scientists allowed the opening of 12 more medical and and the reported lowering of morale." eight more dental 'private colleges in the Health Statistics But science remains a wonderfully rewardstate. w ing career for those who make it through,. In tur the Supreme Court ruled that Group said Sir Michael, .and the report proposes '~~~~~~Andhra Pradesh had a fundamental obligachanges at every level of the present structure.
Firngest athev beg a aee irese r *ch tion to provide a choice of (non-private) "A whole paradigm shift is needed, not Firstly, those beginning a career in research education and asked all state governments, just in Britain but elsewhere," said Bill should be advised -that many will not be able the Medical and Dental Councils of India, McLennan, the newly appointed head of the to make a lifetime career in science. "People thoumak arlifetognimecareeri s cidfen. "Peopey and the University Grants Commission to Government Statistical Service. "Statistics should recognise, saidProfessorDew submit plans on college funding. Chief should be collected according to the needs of professor of geology at Oxford and a member Justice M H Kania observed that racketeering the users rather than the needs of collectors." of the committee that produced the. report, of"thetscomitcedoesn thate prod d te rporat, in private colleges must be stopped.
Mr McLennan was giving his backing to the "thatescencge doesain'tngn hveno e and vation. Andhra Pradesh is not the only state where newly launched Official Health Statistics private medical-education -has been proli-Users Group at a meeting in London this go and do something else." Sir Michael reseacher career adferating. In Karnataka approximately 1000m month. Similar groups have been set up added that researchers "need career advice all rupees in fees are collected annually and a by users of statistics on trade, the labour the way through." One problem, says the single place to study medicine costs up to market, transport, and housing under the report, is that many researchers "are funded 1 .2m rupees. In Maharashtra state in 1988 the auspices of the Statistics Users' Council. by one organisation and employed by another, government banned the collection of private Users at the meeting must have felt that with neither .taking an interest in their educational fees but continued to allow they were pushing at an open door. Providers careers." A major recommendation of the report is "donations" to colleges. Those who proved unsuited to a research career would be helped to transfer to different employment, but the report also proposes a research officer path for those who want to stay in research but who will not become leaders in it. Eventually some high fliers would be given permanent posts. But, says the report, "the old system of awarding tenure was imperfect ver few respondents to the inquiry advocated continuing it."' names and telephone numbers for its statistics division.
To be fair, the user unfriendliness of government statistics over the past decade has hardly been the providers' fault. It dates from the Rayner report of 1981, which laid down that government statistics should be collected primarily to fulfil the government's needs and not those of other interested parties. Swingeing cuts followed in both staff numbers and the volume of statistics collected.
The current poor quality of economic forecasts by the Treasury has been blamed on these cuts; the omission of an adequate commentary to the last decennial supplement on mortality and socioeconomic status published by the Office of Population Censuses and Surveys was the most notorious casualty in health and social security statistics.
Mr McLennan arrived from the Australian government's statistical service six months ago with a reputation for making government statistics more user friendly and for marketing them. The prospect of putting a price on government statistics, however, leaves some providers aghast. "Charge a reasonable price and you'll soon find out whether you're giving value for money," responded Mr McLennan.

EC reaches compromise on maternity benefits
The European Community (EC) has agreed on rules to guarantee a minimum level of maternity leave and pay. In a last minute compromise the deadlock was broken and a new directive agreed in Luxembourg on 19 October. Britain's employment secretary, Mrs Gillian Shephard, has welcomed the compromise and at a meeting of social affairs ministers last week offered to include a clause making it clear that the directive was not "equating pregnancy with sickness." The directive, which will come into force in just over a year, will give women throughout the community a guaranteed 14 weeks' leave with pay at the minimum rate of their country's statutory sick pay as soon as they start work. The directive will also give pregnant women a compulsory two week rest period before birth and outlaw the sacking of women because they are pregnant. The social affairs commissioner, Mrs Vasso Papandreou, had originally proposed a minimum of 14 weeks' leave on full pay. Mrs Shephard resisted this proposal because it would have placed too heavy a burden on British employers.
Italy had been the stumbling block. The Italian government, backed by the European Commission and parliament, wanted mater-nity pay set at 80% of the woman's average earnings rather than the level of sick pay. This had also been called for by Ms Joanna Foster, chairman of the Equal Opportunities Commission and leader of the EC's advisory committee on equal opportunities. Italian women now receive 100% of their normal pay when pregnant. So the government in Rome argued that the new proposals would mean a step back for Italian women, but it is reassured to some extent by the fact that the Council of Ministers will review the directive after five years.
Women in Britain currently have to spend two years in full time employment or five years in part time employment before they are entitled to six weeks' leave at 900/, pay, followed by a flat rate payment for 12 weeks. The Equal Opportunities Commission has complained that the criteria in Britain are so restrictive that one pregnant woman in five does not receive any benefit. Allowances vary across the community. Luxembourg gives 16 weeks on full pay, Denmark 28 weeks at 90% of pay, and Ireland 14 weeks at 70% of pay. In France and Germany women receive 1 00% of salary for 16 and 14 weeks respectively.-